Artigos e Materiais de Revistas Científicas - FM/Outros

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A coleção de Artigos e Materiais de Revistas Científicas engloba artigos originais, artigos de revisão, artigos de atualização, artigos técnicos, relatos de experiências, resenhas, ensaios, editoriais, cartas ao editor, debates, notas científicas e técnicas, depoimentos, entrevistas e pontos de vista. Consideram-se como artigos científicos originais os trabalhos redigidos para divulgação de informações e resultados sobre determinada pesquisa científica, publicados em periódico científico após avaliação por outros pesquisadores.

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  • article 0 Citação(ões) na Scopus
    In vitro and in vivo evaluation of novel chromeno[2,3-d]pyrimidinones as therapeutic agents for triple negative breast cancer
    (2024) CARVALHO, Luisa; LIMA, Fabio Pedroso de; CERQUEIRA, Monica; SILVA, Ana; PONTES, Olivia; OLIVEIRA-PINTO, Sofia; GUERREIRO, Sara; COSTA, Marta D.; GRANJA, Sara; MACIEL, Patricia; LONGATTO-FILHO, Adhemar; BALTAZAR, Fatima; PROENCA, Fernanda; COSTA, Marta
    Triple-negative breast cancer (TNBC) is the most aggressive subtype of breast cancer, and the limited therapeutic options show poor efficacy in patients, associated to severe side effects and development of resistance. Considering that chromene-based scaffolds proved to be attractive candidates for cancer therapy, herein we prepared new chromeno[2,3-d]pyrimidinone derivatives by a simple two step procedure, starting from the reaction of cyanoacetamide and a salicylaldehyde. A cell viability screening in several breast cancer cell lines allowed to identify two promising compounds with IC50 values in the low micromolar range for TNBC cells. These chromenes inhibited cell proliferation, induced cell cycle arrest and triggered cell death through apoptosis. In vivo studies revealed a safe profile in invertebrate and vertebrate animal models and confirmed their capacity to inhibit tumor growth in the CAM model, inducing significant tumor regression after 4 days of treatment. The two compounds identified in this study are promising drug candidates for TNBC treatment and valuable hits for future optimization, using the versatile synthetic platform that was developed.
  • article
    Evidence of a pan-tissue decline in stemness during human aging
    (2024) SANTOS, Gabriel Arantes dos; MAGDALENO, Gustavo Daniel Vega; MAGALHAES, Joao Pedro de
    Despite their biological importance, the role of stem cells in human aging remains to be elucidated. In this work, we applied a machine learning methodology to GTEx transcriptome data and assigned stemness scores to 17,382 healthy samples from 30 human tissues aged between 20 and 79 years. We found that (similar to)60% of the studied tissues exhibit a significant negative correlation between the subject's age and stemness score. The only significant exception was the uterus, where we observed an increased stemness with age. Moreover, we observed that stemness is positively correlated with cell proliferation and negatively correlated with cellular senescence. Finally, we also observed a trend that hematopoietic stem cells derived from older individuals might have higher stemness scores. In conclusion, we assigned stemness scores to human samples and show evidence of a pan-tissue loss of stemness during human aging, which adds weight to the idea that stem cell deterioration may contribute to human aging.
  • article 0 Citação(ões) na Scopus
    Strong OLIG2 expression in supratentorial ependymoma, ZFTA fusion-positive: A potential diagnostic pitfall
    (2024) CASTRO, Joao Victor Alves de; KULIKOWSKI, Leslie Domenicki; WOLFF, Beatriz Martins; NATALINO, Renato; CARRARO, Dirce Maria; TORREZAN, Giovana Tardin; NETO, Cristovam Scapulatempo; AMANCIO, Camila Trolez; CANEDO, Felipe Sales Nogueira Amorim; FEHER, Olavo; COSTA, Felipe D'Almeida
    Ependymomas (EPN) are central nervous system neoplasms that exhibit an ependymal phenotype. In particular, supratentorial EPN (ST-EPN) must be differentiated from more aggressive entities such as glioblastoma, IDH-wildtype. This task is frequently addressed with the use of immunohistochemistry coupled with clinical presentation and morphological features. Here we describe the case of a young adult presenting with migraine-like symptoms and a temporoinsular-based expansile mass that was first diagnosed as a GBM, mostly based on strong and diffuse oligodendrocyte transcription factor 2 (OLIG2) expression. Molecular characterization revealed a ZFTA::RELA fusion, supporting the diagnosis of ST-EPN, ZFTA fusion-positive. OLIG2 expression is rarely reported in tumors other than GBM and oligodendrocyte-lineage committed neoplasms. The patient was treated with radiotherapy and temozolomide after surgery and was alive and well at follow-up. This report illustrates the need to assess immunostains within a broader clinical, morphological and molecular context to avoid premature exclusion of important differential diagnoses.
  • article 5 Citação(ões) na Scopus
    Effect of Different Extraction Methods on Anthocyanin Content in Hibiscus sabdariffa L. and their Antiplatelet and Vasorelaxant Properties
    (2023) MARTINS, Denise Rubinho dos Santos; LESCANO, Caroline Honaiser; JUSTO, Alberto Fernando Oliveira; VICENTE, Julia Modesto; SANTOS, Sergio Henrique Sousa; AGUILAR, Charles Martins; BORGES, Alexandre; OLIVEIRA, Ivan Pires de; SANJINEZ-ARGANDONA, Eliana Janet
    Hibiscus sabdariffa L. is a worldwide component for tea and beverages, being a natural source of anthocyanins, which are associated with cardiovascular activities. To investigate this relationship, we explored different methods of aqueous extraction on the anthocyanin content and antioxidant activity of H. sabdariffa L. calyx extract (HSCE). Pharmacological effects via platelet aggregation, calcium mobilization, cyclic nucleotide levels, vasodilator-stimulated phosphoprotein Ser157 and Ser239, and on the vasomotor response of aortic rings isolated from mice are studied herewith. We found that the application of ultrasonic turbolization, 20 min, combined with acidified water was significantly more effective in the extraction process, providing extracts with the highest levels of anthocyanins (8.73 and 9.63 mg/100 g) and higher antioxidant activity (6.66 and 6.78 mu M trolox/g of sample). HSCE significantly inhibited (100-1000 mu g/mL) arachidonic acid-induced platelet aggregation, reduced calcium mobilization, and increased cAMP and cGMP levels with VASPSer157 and VASPSer239 phosphorylation. Vasorelaxation reduction was confirmed by the aortic rings and endothelium assays treated with nitric oxide synthase inhibitors, soluble guanylyl cyclase (sGC) oxidizing agent, or Ca2+-activated K+ channel inhibitor. The increasing of cGMP levels could be understood considering the sGC stimulation by HSCE compounds in the specific stimulus domain, which allows an understanding of the observed antiplatelet and vasorelaxant properties of H. sabdariffa L. calyx extract.
  • article
    Dentistry medicalization at SUS: a qualitative practice-based perspective
    (2023) SINKOC, Celia Regina; BULGARELI, Jaqueline Vilela; GONDINHO, Brunna Verna Castro; LEME, Pedro Augusto Thiene; SPADACIO, Cristiane; OCTAVIANI, Julia Vitorio; CORTELLAZZI, Karine Laura; POSSOBON, Rosana de Fatima; GUERRA, Luciane Miranda
    This study explores the senses and meanings attributed to dental work in the Brazilian National Health System (SUS) focusing on dentist-patient relations. A qualitative research was conducted with 20 dentists working in a medium-sized municipality in Sao Paulo, divided into three focus groups and asked the guiding question ""What sense or meaning do you attribute to your work here in the city?"" Data were audio-recorded, fully transcribed, and analyzed using thematic content analysis. Floating reading, categorization, and peer discussion of the findings were performed for the final validation, resulting in two categories: 1) Strangeness to patients' needs and the subsequent medicalization of life, and 2) Power and consumption as meanings of practice. In this context, the dental practices showed the differences between patients' needs and those considered relevant by dentists. It also showed the power imbalance between patients and professionals as a hindrance to patients' autonomy. Such meanings seem to cause suffering to these professionals. In conclusion, reflections on health work are paramount to avoid suffering and understand that the practice of these dentists bears many senses and meanings.
  • article 0 Citação(ões) na Scopus
    A primary oral mucosal melanoma of the hard palate with no recurrence: Report of a 10 years follow-up
    (2024) CORREIA-NETO, Ivan Jose; CORREA, Marcelo Brum; ARAUJO, Anna Luiza Damaceno; PENAFORT, Paulo Victor Mendes; COLAFEMINA, Ana Carolina Evangelista; ELIAS, Rogerio de Andrade; SANTOS-SILVA, Alan Roger; VARGAS, Pablo Agustin; LOPES, Marcio Ajudarte
    BackgroundPrimary oral mucosal melanoma (OMM) represents an extremely rare and aggressive tumor that arises from malignant transformation and clonal expansion of melanocytes in the oral cavity. The prognosis of patients affected by OMM is quite unfavorable, with survival rates lower than those described for patients with cutaneous melanoma.Case reportHere, we report a case of OMM in a 59-year-old Caucasian woman, who was referred for evaluation of a large asymptomatic pigmented lesion on the left side of the hard palate under the removable total denture. Incisional biopsy was performed, and histopathological analysis revealed the proliferation of spindle-shaped and pigmented epithelioid cells, with cellular pleomorphism. These cells were positive for Melan A, S-100, HMB-45, SOX-10, and Ki-67 confirming the diagnosis of OMM. The patient underwent partial maxillectomy and adjuvant radiotherapy. After treatment, she was rehabilitated with a palatal obturator prosthesis and has been in follow-up for 10 years with no evidence of disease. Due to the rarity in the oral cavity and the nonspecific signs and symptoms, the diagnosis of OMM is difficult and often overlooked.ConclusionTherefore, multidisciplinary management from diagnosis, treatment, and rehabilitation is important to increase the expectation of cure.
  • article 0 Citação(ões) na Scopus
    Investigating Dyslexia through Diffusion Tensor Imaging across Ages: A Systematic Review
    (2024) MARTINS, Bruce; BABA, Mariana Yumi; DIMATEO, Elisa Monteiro; COSTA, Leticia Fruchi; CAMARA, Aila Silveira; LUKASOVA, Katerina; NUCCI, Mariana Penteado
    Dyslexia is a neurodevelopmental disorder that presents a deficit in accuracy and/or fluency while reading or spelling that is not expected given the level of cognitive functioning. Research indicates brain structural changes mainly in the left hemisphere, comprising arcuate fasciculus (AF) and corona radiata (CR). The purpose of this systematic review is to better understand the possible methods for analyzing Diffusion Tensor Imaging (DTI) data while accounting for the characteristics of dyslexia in the last decade of the literature. Among 124 articles screened from PubMed and Scopus, 49 met inclusion criteria, focusing on dyslexia without neurological or psychiatric comorbidities. Article selection involved paired evaluation, with a third reviewer resolving discrepancies. The selected articles were analyzed using two topics: (1) a demographic and cognitive assessment of the sample and (2) DTI acquisition and analysis. Predominantly, studies centered on English-speaking children with reading difficulties, with preserved non-verbal intelligence, attention, and memory, and deficits in reading tests, rapid automatic naming, and phonological awareness. Structural differences were found mainly in the left AF in all ages and in the bilateral superior longitudinal fasciculus for readers-children and adults. A better understanding of structural brain changes of dyslexia and neuroadaptations can be a guide for future interventions.
  • article 0 Citação(ões) na Scopus
    Know-how of holding a Bioinformatics competition: Structure, model, overview, and perspectives
    (2023) HORACIO, Elvira C. A.; CARVALHO, Lucas M. de; PEREIRA, Gustavo G.; ABRAHIM, Mayla C.; COELHO, Monica P.; JESUS, Deivid A. De; GARCIA, Glen J. Y.; MELO-MINARDI, Raquel C. de; NAGAMATSU, Sheila T.
    The article presents a framework for a Bioinformatics competition that focuses on 4 key aspects: structure, model, overview, and perspectives. Structure represents the organizational framework employed to coordinate the main tasks involved in the competition. Model showcases the competition design, which encompasses 3 phases. Overview presents our case study, the League of Brazilian Bioinformatics (LBB) 2nd Edition. Finally, the section on perspectives provides a brief discussion of the LBB 2nd Edition, along with insights and feedback from participants. LBB is a biannual team competition launched in 2019 to promote the ongoing training of human resources in Bioinformatics and Computational Biology in Brazil. LBB aims to stimulate ongoing training in Bioinformatics by encouraging participation in competitions, promoting the organization of future Bioinformatics competitions, and fostering the integration of the Bioinformatics and Computational Biology community in the country, as well as collaboration among participants. The LBB 2nd Edition was launched in 2021 and featured 251 competitors forming 91 teams. Knowledge competitions promote learning, collaboration, and innovation, which are crucial for advancing scientific knowledge and solving real-world problems. In summary, this article serves as a valuable resource for individuals and organizations interested in developing knowledge competitions, offering a model based on our experience with LBB to benefit all levels of Bioinformatics trainees. There are various methods of learning, and one such approach involves a commonly used in the computing field, fostering competition, where communication, teamwork, group learning, and problem-solving play crucial roles. Similarly, in bioinformatics and computational biology, certain institutions or platforms promote learning through challenges. However, national-level competitions in these domains are relatively scarce. Here, we would like to present a framework for a Bioinformatics competition by showing structure, model, overview, and perspectives, using the League of Brazilian Bioinformatics (LBB) 2nd Edition as case study. LBB is the first bioinformatics competition in Latin America and aims to encompass the diverse multidisciplinary aspects of Bioinformatics and promote networking. In LBB, individuals not only have the opportunity to learn but also get to know one another. Further, to stimulate undergraduate training, we promoted teams with a mixture of different academic backgrounds. This approach promotes integration among participants and facilitates the exchange of information. To ensure that all participants have the opportunity to connect and form teams regardless of their background, we have created the MATCH, a script that allows individuals to be randomly paired with others, enabling them to get to know each other and create teams effectively.This approach fosters collaboration and creates a conducive environment for learning and problem-solving.
  • article 0 Citação(ões) na Scopus
    Pathways and identity: toward qualitative research careers in child and adolescent psychiatry
    (2024) MARTIN, Andres; DIGIOVANNI, Madeline; ACQUAYE, Amber; PONTICIELLO, Matthew; CHOU, Debora Tseng; NETO, Emilio Abelama; MICHEL, Alexandre; SIBEONI, Jordan; PIOT, Marie-Aude; SPODENKIEWICZ, Michel; BENOIT, Laelia
    Objective Qualitative research methods are based on the analysis of words rather than numbers; they encourage self-reflection on the investigator's part; they are attuned to social interaction and nuance; and they incorporate their subjects' thoughts and feelings as primary sources. Despite appearing well suited for research in child and adolescent psychiatry (CAP), qualitative methods have had relatively minor uptake in the discipline. We conducted a qualitative study of CAPs involved in qualitative research to learn about these investigators' lived experiences, and to identify modifiable factors to promote qualitative methods within the field of youth mental health.Methods We conducted individual, semi-structured 1-h long interviews through Zoom. Using purposive sample, we selected 23 participants drawn from the US (n = 12) and from France (n = 11), and equally divided in each country across seniority level. All participants were current or aspiring CAPs and had published at least one peer-reviewed qualitative article. Ten participants were women (44%). We recorded all interviews digitally and transcribed them for analysis. We coded the transcripts according to the principles of thematic analysis and approached data analysis, interpretation, and conceptualization informed by an interpersonal phenomenological analysis (IPA) framework.Results Through iterative thematic analysis we developed a conceptual model consisting of three domains: (1) Becoming a qualitativist: embracing a different way of knowing (in turn divided into the three themes of priming factors/personal fit; discovering qualitative research; and transitioning in); (2) Being a qualitativist: immersing oneself in a different kind of research (in turn divided into quality: doing qualitative research well; and community: mentors, mentees, and teams); and (3) Nurturing: toward a higher quality future in CAP (in turn divided into current state of qualitative methods in CAP; and advocating for qualitative methods in CAP). For each domain, we go on to propose specific strategies to enhance entry into qualitative careers and research in CAP: (1) Becoming: personalizing the investigator's research focus; balancing inward and outward views; and leveraging practical advantages; (2) Being: seeking epistemological flexibility; moving beyond bibliometrics; and the potential and risks of mixing methods; and (3) Nurturing: invigorating a quality pipeline; and building communities.Conclusions We have identified factors that can support or impede entry into qualitative research among CAPs. Based on these modifiable findings, we propose possible solutions to enhance entry into qualitative methods in CAP (pathways), and to foster longer-term commitment to this type of research (identity).
  • article 3 Citação(ões) na Scopus
    MRI with DWI improves detection of liver metastasis and selection of surgical candidates with pancreatic cancer: a systematic review and meta-analysis
    (2024) ALTMAYER, Stephan; ARMELIN, Larissa Maria; PEREIRA, Jussara Soares; CARVALHO, Lis Vitoria; TSE, Justin; BALTHAZAR, Patricia; FRANCISCO, Martina Zaguini; WATTE, Guilherme; HOCHHEGGER, Bruno
    ObjectiveTo perform a systematic review and meta-analysis to evaluate if magnetic resonance imaging (MRI) with diffusion weighted imaging (DWI) adds value compared to contrast-enhanced computed tomography (CECT) alone in the preoperative evaluation of pancreatic cancer.MethodsMEDLINE, EMBASE, and Cochrane databases were searched for relevant published studies through October 2022. Studies met eligibility criteria if they evaluated the per-patient diagnostic performance of MRI with DWI in the preoperative evaluation of newly diagnosed pancreatic cancer compared to CECT. Our primary outcome was the number needed to treat (NNT) to prevent one futile surgery using MRI with DWI, defined as those in which CECT was negative and MRI with DWI was positive for liver metastasis (i.e., surgical intervention in metastatic disease missed by CECT). The secondary outcomes were to determine the diagnostic performance and the NNT of MRI with DWI to change management in pancreatic cancer.ResultsNine studies met the inclusion criteria with a total of 1121 patients, of whom 172 had liver metastasis (15.3%). The proportion of futile surgeries reduced by MRI with DWI was 6.0% (95% CI, 3.0-11.6%), yielding an NNT of 16.6. The proportion of cases that MRI with DWI changed management was 18.1% (95% CI, 9.9-30.7), corresponding to an NNT of 5.5. The per-patient sensitivity and specificity of MRI were 92.4% (95% CI, 87.4-95.6%) and 97.3% (95% CI, 96.0-98.1).ConclusionMRI with DWI may prevent futile surgeries in pancreatic cancer by improving the detection of occult liver metastasis on preoperative CECT with an NNT of 16.6.
  • article 2 Citação(ões) na Scopus
    Pathophysiology-Based Management of Secondary Injuries and Insults in TBI
    (2024) MACEDO FILHO, Leonardo de; FIGUEREDO, Luisa F.; VILLEGAS-GOMEZ, Gustavo Adolfo; ARTHUR, Matthew; PEDRAZA-CIRO, Maria Camila; MARTINS, Henrique; NETO, Joaquim Kanawati; HAWRYLUK, Gregory J.; AMORIM, Robson Luis Oliveira
    Traumatic Brain Injury (TBI) remains a leading cause of morbidity and mortality among all ages; despite the advances, understanding pathophysiological responses after TBI is still complex, involving multiple mechanisms. Previous reviews have focused on potential targets; however, the research on potential targets has continuously grown in the last five years, bringing even more alternatives and elucidating previous mechanisms. Knowing the key and updated pathophysiology concepts is vital for adequate management and better outcomes. This article reviews the underlying molecular mechanisms, the latest updates, and future directions for pathophysiology-based TBI management.
  • article 0 Citação(ões) na Scopus
    It was unusual but amazing: demand creation for PrEP among adolescents' men who have sex with men (MSM) and transgender women (TGW) in Brazil
    (2024) SOUSA, Anderson Reis de; SILVA, Luis Augusto Vasconcelos da; BRASIL, Sandra Assis; ZUCCHI, Eliana Miura; FERRAZ, Dulce Aurelia de Souza; MAGNO, Laio; GRANGEIRO, Alexandre; DOURADO, Ines
    This study aimed to analyze the challenges in demand creation for participation in an HIV pre-exposure prophylaxis (PrEP) project in two Brazilian capitals. This qualitative study was conducted with men who have sex with men and transgender women aged 15 to 19 years who lived in two Brazilian state capitals. For this analysis, 27 semi-structured interviews carried out from 2019 to 2020 were evaluated by reflexive thematic content analysis. For participants, PrEP demand creation was essential for their interaction, mediation, bonding, and attachment and proved effective for PrEP acceptability and adherence. Adolescents' narratives showed that the strategies promoted HIV combination prevention, opened up opportunities for recruitment meetings, helped to negotiate with and convince individuals to use PrEP, strengthened peer education, and evoked a feeling of ""being with"" and ""walking together"" despite the challenges. Face -to -face or online interactions using social technologies played a crucial role in recruiting adolescents for the project, expanding knowledge on PrEP and other combination prevention strategies and access to health services and self-care.
  • article 5 Citação(ões) na Scopus
    Pelvic floor injury during vaginal birth is life-altering and preventable: what can we do about it?
    (2024) DELANCEY, John O. L.; MASTELING, Mariana; PIPITONE, Fernanda; LACROSS, Jennifer; MASTROVITO, Sara; ASHTON-MILLER, James A.
    Pelvic floor disorders after childbirth have distressing lifelong consequences for women, requiring more than 300,000 women to have surgery annually. This represents approximately 10% of the 3 million women who give birth vaginally each year. Vaginal birth is the largest modifiable risk factor for prolapse, the pelvic floor disorder most strongly associated with birth, and is an important contributor to stress incontinence. These disorders require 10 times as many operations as anal sphincter injuries. Imaging shows that injuries of the levator ani muscle, perineal body, and membrane occur in up to 19% of primiparous women. During birth, the levator muscle and birth canal tissues must stretch to more than 3 times their original length; it is this overstretching that is responsible for the muscle tear visible on imaging rather than compression or neuropathy. The injury is present in 55% of women with prolapse later in life, with an odds ratio of 7.3, compared with women with normal support. In addition, levator damage can affect other aspects of hiatal closure, such as the perineal body and membrane. These injuries are associated with an enlarged urogenital hiatus, now known as antedate prolapse, and with prolapse surgery failure. Risk factors for levator injury are multifactorial and include forceps delivery, occiput posterior birth, older maternal age, long second stage of labor, and birthweight of >4000 g. Delivery with a vacuum device is associated with reduced levator damage. Other steps that might logically reduce injuries include manual rotation from occiput posterior to occiput anterior, slow gradual delivery, perineal massage or compresses, and early induction of labor, but these require study to document protection. In addition, teaching women to avoid pushing against a contracted levator muscle would likely decrease injury risk by decreasing tension on the vulnerable muscle origin. Providing care for women who have experienced difficult deliveries can be enhanced with early recognition, physical therapy, and attention to recovery. It is only right that women be made aware of these risks during pregnancy. Educating women on the long-term pelvic floor sequelae of childbirth should be performed antenatally so that they can be empowered to make informed decisions about management decisions during labor.
  • article 0 Citação(ões) na Scopus
    Changes in use of preventive medications after assessment of chest pain by coronary computed tomography angiography: A meta-analysis
    (2024) GENEROSO, Giuliano; AGARWAL, Vikram; SHAW, Leslee J.; CARDOSO, Rhanderson; BLANKSTEIN, Ron; BITTENCOURT, Marcio S.
    Background: Coronary computed tomography angiogram (CCTA) is a crucial tool for diagnosing CAD, but its impact on altering preventive medications is not well-documented. This systematic review aimed to compare changes in aspirin and statin therapy following CCTA and functional stress testing in patients with suspected CAD, and in those underwent CCTA when stratified by the presence/absence of plaque. Results: Eight studies involving 42,812 CCTA patients and 64,118 cardiac stress testing patients were analyzed. Compared to functional testing, CCTA led to 66 % more changes in statin therapy (pooled RR, 95 % CI [1.28 -2.15]) and a 74 % increase in aspirin prescriptions (pooled RR, 95 % CI [1.34 -2.26]). For medication modi fications based on CCTA results, 13 studies (47,112 patients with statin data) and 11 studies (12,089 patients with aspirin data) were included. Patients with any plaque on CCTA were five times more likely to use or intensify statins compared to those without CAD (pooled RR, 5.40, 95 % CI [4.16 -7.00]). Significant heterogeneity remained, which decreased when stratified by diabetes rates. Aspirin use increased eightfold after plaque detection (pooled RR, 8.94 [95 % CI, 4.21 -19.01]), especially with obstructive plaque findings (pooled RR, 9.41, 95 % CI [2.80 -39.02]). Conclusion: In conclusion, CCTA resulted in higher changes in statin and aspirin therapy compared to cardiac stress testing. Detection of plaque by CCTA significantly increased statin and aspirin therapy.
  • article 0 Citação(ões) na Scopus
    Storylines of family medicine V: ways of thinking - honing the therapeutic self
    (2024) VENTRES, William B.; STONE, Leslie A.; SHAPIRO, Johanna F.; HAQ, Cynthia; LEAO, Jessica R. B.; JR, Donald E. Nease; GRANT, Liz; MERCER, Stewart W.; GILLIES, John C. M.; BLASCO, Pablo Gonzalez; BENEDETTO, Maria Auxiliadora C. De; MORETO, Graziela; LEVITES, Marcelo R.; DEVOE, Jennifer E.; PHILLIPS, William R.; UYGUR, Jane M.; EGNEW, Thomas R.; STANLEY, Colette S.
    Storylines of Family Medicine is a 12-part series of thematically linked essays with accompanying illustrations that explore the many dimensions of family medicine, as interpreted by individual family physicians and medical educators in the USA and elsewhere around the world. In 'V: ways of thinking-honing the therapeutic self', authors present the following sections: 'Reflective practice in action', 'The doctor as drug-Balint groups', 'Cultivating compassion', 'Towards a humanistic approach to doctoring', 'Intimacy in family medicine', 'The many faces of suffering', 'Transcending suffering' and 'The power of listening to stories.' May readers feel a deeper sense of their own therapeutic agency by reflecting on these essays.
  • article 7 Citação(ões) na Scopus
    Benefits of probiotic use on COVID-19: A systematic review and meta-analysis
    (2024) VIANA, Suelen Neris Almeida; PEREIRA, Tamires do Reis Santos; ALVES, Janaina de Carvalho; CASTRO, Caroline Tianeze de; SILVA, Lucas Santana C. da; PINHEIRO, Lucio Henrique Sousa; ROSELINO, Mariana Nougalli
    SARS-CoV-2 is the virus that causes the new global pandemic, which has already resulted in millions of deaths, affecting the world's health and economy. Probiotics have shown benefits in a variety of diseases, including respiratory infections, and may be beneficial in the adjunctive treatment of COVID-19. This study analyzed the effectiveness of probiotics as adjunctive treatment in reducing symptoms of patients with COVID-19, through a systematic review with meta-analysis. The EMBASE (Elsevier), Pubmed, Scopus, Web of Science and International Clinical Trials Registry Platform (ICTRP) were searched through March 16, 2022. The risk ratio (RR) with 95% confidence intervals (CIs) was estimated using a fixed-effect model. RoB 2 and ROBINS I were used to assess the risk of bias of the included studies. Nine studies were included (7 clinical trials and 2 cohorts), of which three clinical trials comprised the meta-analysis. Results showed that probiotics were associated with a significant 51% reduction in symptoms reported by COVID-19 patients (RR 0.49, 95% CI 0.40-0.61). There was a significant improvement in cough (RR 0.56, 95% CI 0.37-0.83), headaches (RR 0.17, 95% CI 0.05-0.65), and diarrhea (RR 0. 33, 95% CI 0.12-0.96) of patients on probiotic therapy. These findings suggest that probiotic supplementation is effective in improving symptoms of COVID-19.
  • article 0 Citação(ões) na Scopus
    The impact of effective participation in stopping misinformation: an approach based on branching processes
    (2024) GOMEZ, Luz Marina; VALDIVINO, V.; RODRIGUEZ, Pablo M.
    The emergence of research that focuses on understanding the spreading and impact of disinformation is increasing year after year. Most of the time, the purpose of those who start the spreading of intentionally false information that is designed to cause harm is to catalyze its fast transformation into misinformation, which is the false content shared by people who do not realize it is false or misleading. Our interest is in discussing the role of people who decide to adopt an active role in stopping the propagation of information when they realize that it is false. For this, we formulate two simple probabilistic models to compare misinformation spreading in possible scenarios for which there is a passive or an active environment of aware individuals. With aware individuals, we mean those individuals who realize that a piece of given information is false or misleading. In the passive environment, we assume that if one of an aware individual is exposed to the misinformation then he/she will not spread it. In the active environment, we assume that if one of an aware individual is exposed to the misinformation then he/she will not spread it, but also he/she will stop the propagation to other individuals from the individual who contacted him/her. We appeal to the theory of branching processes to analyze propagation in both scenarios, and we discuss the role and the impact of effective participation in stopping misinformation. We show that the propagation reduces drastically, provided we assume an active environment. We also obtain theoretical and computational results to measure such a reduction, which in turn depends on the proportion of aware individuals and the number of potential contacts of each individual, which is assumed to be random.
  • article 0 Citação(ões) na Scopus
    Early Leishmania infectivity depends on miR-372/373/520d family-mediated reprogramming of polyamines metabolism in THP-1-derived macrophages
    (2024) FERNANDES, J. C. R.; MUXEL, S. M.; LOPEZ-GONZALVEZ, M. A.; BARBAS, C.; FLOETER-WINTER, L. M.
    Leishmania amazonensis is a protozoan that primarily causes cutaneous leishmaniasis in humans. The parasite relies on the amino acid arginine to survive within macrophages and establish infection, since it is a precursor for producing polyamines. On the other hand, arginine can be metabolized via nitric oxide synthase 2 (NOS2) to produce the microbicidal molecule nitric oxide (NO), although this mechanism does not apply to human macrophages since they lack NOS2 activity. MicroRNAs (miRNAs) are small noncoding RNAs that regulate gene expression at posttranscriptional levels. Our previous work showed that mmu-miR-294 targets Nos2 favoring Leishmania survival in murine macrophages. Here, we demonstrate that human macrophages upregulate the hsa-miR-372, hsa-miR-373, and hsa-miR-520d, which present the same seed sequence as the murine mmu-miR-294. Inhibition of the miR-372 impaired Leishmania survival in THP-1 macrophages and the effect was further enhanced with combinatorial inhibition of the miR-372/373/520d family, pointing to a cooperative mechanism. However, this reduction in survival is not caused by miRNA-targeting of NOS2, since the seed-binding motif found in mice is not conserved in the human 3 ' UTR. Instead, we showed the miR-372/373/520d family targeting the macrophage's main arginine transporter SLC7A2/CAT2 during infection. Arginine-related metabolism was markedly altered in response to infection and miRNA inhibition, as measured by Mass Spectrometry-based metabolomics. We found that Leishmania infection upregulates polyamines production in macrophages, as opposed to simultaneous inhibition of miR-372/373/520d, which decreased putrescine and spermine levels compared to the negative control. Overall, our study demonstrates miRNA-dependent modulation of polyamines production, establishing permissive conditions for intracellular parasite survival. Although the effector mechanisms causing host cell immunometabolic adaptations involve various parasite and host-derived signals, our findings suggest that the miR-372/373/520d family may represent a potential target for the development of new therapeutic strategies against cutaneous leishmaniasis.
  • article 0 Citação(ões) na Scopus
    Asleep versus awake GPi DBS surgery for Parkinson's disease: A systematic review and meta-analysis
    (2024) DINIZ, Jordana Borges C.; ELVIR, Francisco Alfonso Rodriguez; SANTANA, Lais Silva; OLIVEIRA, Helen Michaela de; LARCIPRETTI, Anna Laura Lima; MELO, Tiago Muniz Vieira de; BARROSO, Douglas Carneiro; GOMES, Fernando Cotrim; POLVERINI, Allan Dias; MILANESE, Vanessa
    Background: Patients with Parkinson's Disease (PD) who receive either asleep image-guided subthalamic nucleus deep brain stimulation (DBS) or the traditional awake technique have comparable motor outcomes. However, there are fewer studies regarding which technique should be chosen for globus pallidus internus (GPi) DBS. This systematic review and meta-analysis aims to compare the accuracy of lead placement and motor outcomes of asleep versus awake GPi DBS PD population. Methods: We systematically searched PubMed, Embase, and Cochrane for studies comparing asleep vs. awake GPi DBS lead placement in patients with PD. Outcomes were spatial accuracy of lead placement, measured by radial error between intended and actual location, motor improvement measured using (UPDRS III), and postoperative stimulation parameters. Statistical analysis was performed with Review Manager 5.1.7. and OpenMeta [Analyst]. Results: Three studies met inclusion criteria with a total of 247 patients. Asleep DBS was used to treat 192 (77.7 %) patients. Follow-up ranged from 6 to 48 months. Radial error was not statistically different between groups (MD -0.49 mm; 95 % CI -1.0 to 0.02; I2 = 86 %; p = 0.06), with a tendency for higher target accuracy with the asleep technique. There was no significant difference between groups in change on motor function, as measured by UPDRS III, from pre- to postoperative (MD 8.30 %; 95 % CI -4.78 to 21.37; I2 = 67 %, p = 0.2). There was a significant difference in postoperative stimulation voltage, with the asleep group requiring less voltage than the awake group (MD -0.27 V; 95 % CI -0.46 to - 0.08; I2 = 0 %; p = 0.006). Conclusion: Our meta-analysis indicates that asleep image-guided GPi DBS presents a statistical tendency sug- gesting superior target accuracy when compared with the awake standard technique. Differences in change in motor function were not statistically significant between groups.
  • article 0 Citação(ões) na Scopus
    Functional Anatomy of Urogenital Hiatus Closure: the Perineal Complex Triad Hypothesis
    (2024) DELANCEY, John O.; PIPITONE, Fernanda; MASTELING, Mariana; XIE, Bing; ASHTON-MILLER, James A.; CHEN, Luyun
    IntroductionUrogenital hiatus enlargement is a critical factor associated with prolapse and operative failure. This study of the perineal complex was performed to understand how interactions among its three structures: the levator ani, perineal membrane, and perineal body-united by the vaginal fascia-work to maintain urogenital hiatus closure.MethodsMagnetic resonance images from 30 healthy nulliparous women with 3D reconstruction of selected subjects were used to establish overall geometry. Connection points and lines of action were based on perineal dissection in 10 female cadavers (aged 22-86 years), cross sections of 4 female cadavers (aged 14-35 years), and histological sections (cadavers aged 16 and 21 years).ResultsThe perineal membrane originates laterally from the ventral two thirds of the ischiopubic rami and attaches medially to the perineal body and vaginal wall. The levator ani attaches to the perineal membrane's cranial surface, vaginal fascia, and the perineal body. The levator line of action in 3D reconstruction is oriented so that the levator pulls the medial perineal membrane cranio-ventrally. In cadavers, simulated levator contraction and relaxation along this vector changes the length of the membrane and the antero-posterior diameter of the urogenital hiatus. Loss of the connection of the left and right perineal membranes through the perineal body results in diastasis of the levator and a widened hiatus, as well as a downward rotation of the perineal membrane.ConclusionInterconnections involving the levator ani muscles, perineal membrane, perineal body, and vaginal fascia form the perineal complex surrounding the urogenital hiatus in an arrangement that maintains hiatal closure.